Fibrinolysed patients in burgundy: identiFication method and description

Abstract

introduction/context: Fibrinolysis for patients with acute ischemic is based on an injection of Actilyse®. Actilyse is a very expensive treatment, but is not reimbursed by the health insurance agency. This situation has led to questions about the identification of fibrinolysed patients in the French administrative claims database. objectives: This study aims to identify such patients in the French administrative claims database (PMSI), and to describe them. Materials and methods: According to the patient-register routinely filled in at the two stroke units in Burgundy between 2007 and 2011, we identified fibrinolysed patients in the PMSI through multiple matching variables. We then studied the patients’ characteristics: clinical diagnosis, demographic description and geographical location. results: Hospital stays for fibrinolysis were mainly identified for men, whose first diagnosis was ischemic stroke. The mean hospital stay was 12.4 days. Both Burgundy stroke units mainly treated patients from their own ‘département’, but the study showed that many patients came from other ‘départements’. discussion/conclusion: This work demonstrated that identifying fibrinolysed patients in a large health database is possible. However, this identification requires access to care-structures internal data, like admission registers and internal administrative health data for large establishments. Furthermore, the study showed the interest of deploying telemedicine in Burgundy because of the aging population in several territories and their remoteness from the nearest stroke units.